Okuno T, Masuda M, Yamazaki A, Hirokawa M, Matsushita K, Asakura S
Department of Urology, Fujisawa City Hospital.
Nihon Hinyokika Gakkai Zasshi. 1991 Feb;82(2):312-5. doi: 10.5980/jpnjurol1989.82.312.
A case of malignant fibrous histiocytoma (MFH) of the urinary bladder was presented. A 59-year-old man visited our hospital with a chief complaint of gross hematuria with clots. Intravenous urography revealed a filling defect on the left side of the bladder. CT scan demonstrated that the tumor invaded the bladder wall deeply. The histology of the biopsy specimens obtained by TUR was suspected to be transitional cell carcinoma. Bleeding from the bladder was so severe that a lot of units of blood transfusion were required in order to compensate for anemia before total cystectomy was performed. The tumor was hemispheric, moderately demarcated, measuring 5.5 cm x 4.0 cm x 5.5 cm, and located at the posterior wall. The histological diagnosis was malignant fibrous histiocytoma, inflammatory type, with venous invasion of tumor cells. Postoperatively, the patient received 5 courses of combination chemotherapy of adriamycin (100 mg/body, day 1) and dacarbazine (400 mg/body, day 1-5). He is alive with no evidence of local and metastatic disease 24 months after operation, in spite of the poor prognosis predicted from the histological findings. MFH of the urinary bladder is very rare. We also made a brief review of prior reports on this disease.
本文报告一例膀胱恶性纤维组织细胞瘤（MFH）。一名59岁男性因肉眼血尿伴血凝块为主诉前来我院就诊。静脉肾盂造影显示膀胱左侧有充盈缺损。CT扫描显示肿瘤已深深侵犯膀胱壁。经尿道切除术（TUR）获取的活检标本组织学检查怀疑为移行细胞癌。膀胱出血非常严重，以至于在进行全膀胱切除术之前，需要多次输血以纠正贫血。肿瘤呈半球形，边界中等清晰，大小为5.5 cm×4.0 cm×5.5 cm，位于后壁。组织学诊断为炎症型恶性纤维组织细胞瘤，伴有肿瘤细胞的静脉浸润。术后，患者接受了5个疗程的阿霉素（100 mg/体，第1天）和达卡巴嗪（400 mg/体，第1 - 5天）联合化疗。尽管根据组织学结果预测预后较差，但术后24个月患者仍存活，无局部及转移病灶证据。膀胱MFH非常罕见。我们还对该疾病之前的报道进行了简要回顾。
